THE face of the National Health Service is changing all the time. Long hospital stays are being replaced by day surgery where patients are whisked in, treated and sent home within a few hours. But the advent of technology has also allowed NHS staff to develop their own skills and some are doing jobs they never imagined they would ever do. To mark the start of NHS Week, chief reporter JASON HEAVEY spoke to two nurses who are getting to grips with pioneering roles in East Lancashire.

ANGELA Perkins is a woman with a mission. After 13 years as a mental health nurse at Burnley General Hospital, she decided to take the plunge, jump across the East Lancashire border and take up a new role for the Blackburn, Hyndburn and Ribble Valley NHS Trust.

Dozens of patients every month, who are either suicidal or have mental health problems, come face-to-face with Angela or her colleague Shaun Kenny.

In fact, every patient with a mental health problem who passes through Blackburn Infirmary's casualty department is referred to Angela or Shaun for assessment.

As mental health liaison nurses, their job is to intervene and try to help people get the correct treatment.

Before January there was no such staff in post in Blackburn, Hyndburn and Ribble Valley and there was always the danger of people in genuine need of specialist help falling through the net.

Mother-of-two Angela, 35, who lives in Burnley, is there to make sure that does not happen. Apart from casualty referrals, she also assesses patients from the dozens of hospital wards in Blackburn.

She said: "There has been a great increase in suicide rates across the country and what we are trying to do is to intervene at an earlier stage. "Although we are not actually based in casualty, we are in constant touch. We are also trying to stop people from returning to the accident and emergency unit time and time again.

"In the long term, we hope we will be helping people with mental health problems find the treatment they need."

Angela and Shaun have seen 400 new patients since the start of the year and see about 60 and 70 new referrals a month.

When Eileen Barnes joined Blackburn Infirmary's endoscopy unit in 1984, she never thought she would be carrying out tasks normally undertaken by doctors.

For 13 years she worked as an endoscopy nurse, assisting the medical staff, but she has now become part and parcel of what was once the doctors' domain.

Eileen, known fondly as Millie, embarked on a training programme in 1997 which involved in-house tuition from consultants and a course at Fazackerley Hospital in Liverpool.

Now mother-of-two Eileen, who lives in Accrington, has her own list of patients and carries out gastroscopy examinations on dozens of patients.

The specialised test involves a tube being inserted down a patient's mouth into the stomach. Eileen will then discuss what she has found with the patients, who normally undergo local anaesthetic. She said: "Initially, reports came out of the USA about nurses taking on tasks which had previously been in the medical domain. Training programmes have since been introduced over here and nurses are moving forward.

"The benefit for patients has been that waiting lists have come down from 10 months to about six to eight weeks. It has also released the senior endoscopists to do more therapeutic work.

"I have had no complaints from patients. In fact they seem to open up and talk a bit more to nurses."

John Thomas, chief executive of the trust, said: "The posts undertaken by Eileen Barnes and Angela Perkins are just two examples of how the nursing role is being developed to bring about service developments and improve patient care.

"The trust recognises that it must continue to invest in the skills and expertise of all its staff to meet increasing demand."

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